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INTRODUCTION: Granulocyte and monocyte adsorptive apheresis (GMA) removes neutrophils and monocytes from peripheral blood, preventing their incorporation into the inflamed tissue also influencing cytokine balance. Published therapeutic efficacy in ulcerative colitis (UC) is more consistent than in Crohn's disease (CD). We assessed clinical efficacy of GMA in UC and CD 4 weeks after last induction session, at 3 and 12 months, sustained remission and corticosteroid-free remission. PATIENTS AND METHOD: Retrospective observational study of UC and CD patients treated with GMA. Partial Disease Activity Index-DAIp in UC and Harvey-Bradshaw Index-HBI in CD assessed efficacy of Adacolumn® with induction and optional maintenance sessions. RESULTS: We treated 87 patients (CD-25, UC-62), 87.3% corticosteroid-dependent (CSD), 42.5% refractory/intolerant to immunomodulators. In UC, remission and response were 32.2% and 19.3% after induction, 35.5% and 6.5% at 12 weeks and 29% and 6.5% at 52 weeks. In CD, remission rates were 60%, 52% and 40% respectively. In corticosteroid-dependent and refractory or intolerant to INM patients (UC-41, CD-14), 68.3% of UC achieved remission or response after induction, 51.2% at 12 weeks and 46.3% at 52 weeks, and 62.3%, 64.3% and 42.9% in CD. Maintained remission was achieved by 66.6% in CD and 53.1% in UC. Up to 74.5% of patients required corticosteroids at some timepoint. Corticosteroid-free response/remission was 17.7% in UC and 24% in CD. CONCLUSIONS: GMA is a good therapeutic tool for both in UC and CD patients. In corticosteroid-dependent and refractory or intolerant to INM patients it avoids biological therapy or surgery in up to 40% of them in one year.
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Objetivo: Diseño y validación de un instrumento de medida de la satisfacción manifestada por pacientes en tratamiento oncológico en régimen ambulatorio en Hospital de Día. Método: Estudio transversal descriptivo de periodo mediante la administración de un cuestionario a una muestra de 148 pacientes oncológicos atendidos en régimen ambulatorio en el Hospital Costa del Sol, Marbella. Se analizaron la validez, consistencia interna, y la reproducibilidad de los items del instrumento. Resultados: La correlación ítem-escala mostró coeficientes que superaban el umbral de adecuación de 0,30. El análisis factorial de los componentes determinó un adecuado ajuste dado un valor de KMO de 0,91 y una p < 0,001 en el test de esfericidad de Barlett. El análisis de consistencia interna determinó coeficientes de alfa de Cronbach > 0,70. El retest determinó porcentajes de acuerdo absoluto superiores al 90% en todos los ítems, y valores de kappa puntuales que oscilaban entre 0,52 y 0,93. Conclusión: Los resultados obtenidos permiten determinar que a priori el cuestionario es un instrumento fiable y válido para su utilización en lengua castellana
Purpose: Design and validation of an instrument measuring the satisfaction of patients receiving ambulatory cancer therapy in a day hospital. Methods: Descriptive cross-sectional study involving the administration of a questionnaire to a sample of 148 cancer patients seen in an ambulatory setting at Hospital Costa del Sol, Marbella (Spain). The validity, internal consistency and reproducibility of the instruments items were analysed. Results: In the item-scale correlation, the coefficients obtained were above the adequacy threshold of 0.30. Results showed that the principal components factor analysis was appropriate based on a KMO value of 0.91 and a p < 0.001 for Bartlett's sphericity test. The internal consistency analysis established Cronbach's alpha coefficients > 0.70. A test-retest analysis revealed absolute percentage agreements greater than 90% for all items and kappa point estimates ranging from 0.52 to 0.93. Conclusions: The results obtained show that the questionnaire is, a priori, a reliable and valid instrument for use in Spanish language
